Sadly, a long and unhappy life is the harsh reality for many of the country's elderly and – with the population ageing – 21st-century Britain is in a critical condition and it could get worse, much worse.

"It's been said so many times before, but it's true – as a society we don't value older people," says Professor Alan Walker, from the University of Sheffield. "It's strange because on a family level we do. Grandparents command great respect and their contribution in terms of looking after grandchildren and generally being dependable is massive.

"However, outside those family circles something strange happens and society not only overlooks the needs of elderly, but at times seems to go out of its way to make their lives as difficult as possible.

"No one is asking for special treatment, but what we are asking for is equality."

Prof Walker has spent the last 30 years researching social policy in relation to the elderly and his lifetime's contribution was recently recognised with two awards made by the British Society of Gerontology, dedicated to the study of ageing, and the Social Policy Association.

Much has been written about the potential timebomb of a society whose over-80s' population is expected to double to five million by 2031, but the wealth of statistics often obscures the real core of the problem.

"What everyone wants is to be healthy for as long as possible, basically we want to live longer and die faster," says Prof Walker.

"This is not rocket science, but we need to be open to change. When you speak to older people and I have spoken to a lot, what they tell you is that they want to be involved in deciding their future, they don't want to feel like they are second-class citizens and that feeling reaches across everything from housing, the health service and social care. They don't want to be told what's good for them."

Prof Walker describes the services provided for the elderly as patchy and even in areas with the best facilities fundamental mistakes are being made.

Instead of encouraging the elderly to live fulfilling and independent lives, many decisions taken with their supposed best interests at heart often have the reverse effect, with Prof Walker pointing to the fact that two-fifths of those in nursing homes find themselves in residential care following a fall.

"What happens so often is that they are taken into hospital where their injuries are dealt with, but not the wider issues," he says. "It's not something we are particularly good at responding to.

"What we should be investing in is support networks to get more of these people back into their homes. So often they end up in care homes where depression sets in and from there, in terms of morale, it is a downward spiral.

"The same situation occurs when someone's partner dies. At the time when they most need to be in touch with society they find themselves becoming increasingly isolated."

Inevitably there is a question of money. However, the complaint that the NHS is not a bottomless pit and that it is simply extra strain on already overstretched resources is begin to sound a little hollow.

In the BBC series Can Gerry Robinson Fix the NHS?, the entrepreneur exposed the massive failings in a system which is leaking money, where warped priorities are dreamt up with little reference to the people they are supposed to be helping and where in some departments the wheels of change have not turned for some years. While there is little doubt about the dedication of doctors and nursing staff, they often find themselves working in an antiquated system which refuses to adapt.

"If we do absolutely nothing at all there will be a slight and gradual improvement in the health of older people simply because the country's general standard of living is improving," says Prof Walker. "But compared to other major European countries Britain still lags behind.

"It's not that there isn't the money to address these issues, there is, but at the moment
it's invested in all the wrong
areas. Other places have
concentrated much more on public health measures and education and we need to follow suit and quickly.

"The NHS is a massive organisation, but at the moment it works like an emergency system. When people are seriously ill, it reacts and nine times out of 10 it's very good, but we really need to be looking at preventative measures like they do in Japan, Australia and North America. We are slowly changing, but we are still way behind the game."

Prof Walker is now leading a £20m five-year project called the New Dynamics of Ageing which was set up to look at everything from chronic disease and retirement to the problems faced by the rural elderly and the benefits technology could bring.

The initiative hopes to pool resources and by 2011 the idea is that it will have amassed the very best knowledge to mould future social policy.

"What we need to do is address the problems at source which will ultimately save resources," adds Prof Walker. "There are tiny things which could be introduced tomorrow. For example, there is wonderful evidence from the US that in care homes some basic muscle training exercises, and we're talking here for people who are 90-plus, has an amazing impact on morale.

"In the 21st-century we know much more about the causes of disability and ill health, but the real challenge is a cultural change and what we need is a big push from government and the Primary Care Trusts.

"There is a document lurking in Whitehall called Active Ageing which is not just about older people, but about encouraging everyone to be aware of their health and the ageing process, because, let's face it, we start getting older as soon as we leave the womb.

"Of course I worry about getting older, but I am optimistic that things will change. A decade ago, policy makers did their own thing, but now there is increasing awareness that the best decisions are made on the basis of scientific research

"The one thing we have to hope is that as the baby boom generation gets older they will continue to be feisty and demanding. I'm part of that generation and I'm confident we won't be told what to do."


'Mum was a smart lady, but she looked like a bag lady'


When the matron and her deputy were found guilty of neglect at a West Yorkshire nursing home, it brought into focus the plight elderly people can face. Fiona Evans speaks to the victims' families.

Mandy Hirst will never forget the day she walked into Laurel Bank nursing home, in Halifax, to find her mother Agnes Moore – a double amputee – lying on a bed with a towel placed between her legs and her dignity shredded.

The 66-year-old Halifax pensioner, who had spent her working life as a care assistant for the elderly, had no access to her wheelchair or toiletries and the only towel in the room was the one used in place of an incontinence pad.

Mrs Moore had lost her husband, Brian, to a terminal illness, four days after the couple had moved into the home and was still coming to terms with her grief when her daughter found her that day.

"She had had one leg removed in 2003," said Mrs Hirst, of Halifax. "She waited for the operation to remove her second leg because she did not want to leave my dad's side."

"She could not remember his funeral because she had been given so much morphine. She is still persecuted by that."

Mrs Hirst was stunned when the home's matron, Patricia Linda Parker, was allowed to continue working at the home, despite admitting neglecting her mother and two other elderly patients, at a disciplinary hearing by the Nursing and Midwifery Council's professional conduct committee last week.

Mrs Parker's former deputy, Elisabeth Uttley, who retired two years ago and failed to attend the hearing, was struck off the nursing register after the committee heard the senior nurses were responsible for a catalogue of failings against Mrs Moore, Lily Leatham and Ivy McGuire.

Despite her ordeal, Mrs Moore, now 69, is living independently in sheltered housing and her story's postscript is one of the brighter chapters of the shocking story of neglect heard by the committee.

Pensioner Lily Leatham also survived but her daughters say the treatment she received was not without its legacy.

The widow could communicate with relatives when she walked, with help, into Laurel Bank in November 2002.

By the following May, the pensioner, now 83, was admitted to hospital – for what was to turn into an 89-day stay – suffering horrific pressure sores on her hip and heel and malnutrition.

"She looked unkempt," said her daughter Marilyn Hartley, who along with her sister Dianne Newman regularly visited her mother. "Mum was a smart lady, but she looked like a bag lady. When they took mum in the ambulance they were not sure she would make the journey. They took away what quality of life she had."

The sisters, who have waited over three years for the NMC hearing, had put their trust in the senior nurses at the home and had to sell their mother's home, where she had lived for 17 years, to pay almost £10,000 in fees at Laurel Bank.

More than four years after Mrs Leatham left Laurel Bank in an ambulance, her daughters say she has settled into a new home in Leeds where they praised the standard of care she receives.

But they still ask questions – lots of them – and remain
vigilant.